{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T02:12:29Z","timestamp":1776132749266,"version":"3.50.1"},"reference-count":23,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2012,2,8]],"date-time":"2012-02-08T00:00:00Z","timestamp":1328659200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transfusion"],"published-print":{"date-parts":[[2012,9]]},"abstract":"<jats:p><jats:bold>BACKGROUND:<\/jats:bold> The objective was to determine the incidence and volume of fetomaternal hemorrhage (FMH) in normal vaginal delivery and in delivery by cesarean section. Determination of these variables would enable optimalization of guidelines for D alloimmunization prophylaxis.<\/jats:p><jats:p><jats:bold>STUDY DESIGN AND METHODS:<\/jats:bold> In a prospective cohort study, a total of 3457 examinations were performed, 2413 after normal vaginal delivery and 1044 after cesarean delivery. FMH was assessed by flow cytometry. (FMH\u2003is\u2003fetal red blood cell [RBC] volume; fetal blood volume is double [expected fetal hematocrit is 50%].)<\/jats:p><jats:p><jats:bold>RESULTS:<\/jats:bold> The fetal RBC volume diagnosed in maternal circulation after delivery ranged from insignificant FMH\u2003of not more than 0.1\u2003mL to excessive FMH\u2003of\u200365.9\u2003mL (median, 0.7; mean, 0.78; SD, 1.48). FMH\u2003of more than 2.5\u2003mL (immunoglobulin [Ig] G anti\u2010D insufficient dose 50\u2003\u00b5g) was observed in 1.4% (49\/3457) and excessive volumes of FMH\u2003of more than\u20035\u2003mL (insufficient dose, 100\u2003\u00b5g) in 0.29% (10\/3457). Delivery by cesarean section presented a higher risk of incidence of FMH\u2003of more than\u20032.5\u2003mL (odds ratio, 2.2; p\u2003=\u20030.004) when compared with normal vaginal delivery. It did not, however, present a significant risk factor for the incidence of excessive volumes of FMH\u2003of more than\u20035\u2003mL.<\/jats:p><jats:p><jats:bold>CONCLUSION:<\/jats:bold> During normal vaginal delivery as well as during delivery by cesarean section, FMH\u2003of less than 5\u2003mL occurs in the great majority of cases, and thus for the prevention of D alloimmunization, an IgG anti\u2010D dose of 100\u2003\u00b5g should be sufficient. Contrarily, only rarely does greater FMH occur and delivery by cesarean section does not present a risk factor.<\/jats:p>","DOI":"10.1111\/j.1537-2995.2011.03536.x","type":"journal-article","created":{"date-parts":[[2012,2,8]],"date-time":"2012-02-08T08:42:30Z","timestamp":1328690550000},"page":"1977-1982","source":"Crossref","is-referenced-by-count":16,"title":["Fetomaternal hemorrhage in normal vaginal delivery and in delivery by cesarean section"],"prefix":"10.1111","volume":"52","author":[{"given":"Marek","family":"Lubusky","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ondrej","family":"Simetka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Studnickova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Prochazka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marta","family":"Ordeltova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katherine","family":"Vomackova","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2012,2,8]]},"reference":[{"issue":"2","key":"e_1_2_9_2_2","article-title":"Anti\u2010D administration after childbirth for preventing Rhesus alloimmunisation","author":"Crowther C","year":"2000","journal-title":"Cochrane Database Syst Rev"},{"key":"e_1_2_9_3_2","doi-asserted-by":"publisher","DOI":"10.5507\/bp.2010.003"},{"key":"e_1_2_9_4_2","unstructured":"MoiseKJJr.Prevention of Rh (D) alloimmunization. The UpToDate database of systematic reviews2011(updated January 2011). [cited 2011 Aug 27]. Available from: URL:http:\/\/www.uptodate.com"},{"key":"e_1_2_9_5_2","first-page":"97","volume-title":"Alloimmune disorders of pregnancy: anaemia, thrombocytopenia and neutropenia in the fetus and newborn","author":"Urbaniak S","year":"2002"},{"key":"e_1_2_9_6_2","unstructured":"Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG).Guidelines for the use of Rh D immunoglobulin (anti\u2010D) in obstetrics in Australia.2007. [cited 2011 Aug 27]. Available from: URL:http:\/\/www.ranzcog.edu.au\/publications\/statements\/C\u2010obs6.pdf"},{"key":"e_1_2_9_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1701-2163(16)30995-1"},{"key":"e_1_2_9_8_2","unstructured":"American College of Obstetricians and Gynecologists (ACOG).Prevention of RhD alloimmunization. ACOG practice bulletin no. 4. Washington DC 1999."},{"key":"e_1_2_9_9_2","unstructured":"Royal College of Obstetrics and Gynaecology.United Kingdom (RCOG). Green top guidelines (Green\u2010top 22). Anti\u2010D immunoglobulin for Rh prophylaxis2002. [cited 2011 Aug 27]. Available from: URL:http:\/\/www.rcog.org.uk\/womens\u2010health\/clinical\u2010guidance\/use\u2010anti\u2010d\u2010immunoglobulin\u2010rh\u2010prophylaxis\u2010green\u2010top\u201022"},{"key":"e_1_2_9_10_2","first-page":"328","article-title":"Current status of immunoprophylaxis with anti\u2010D immunoglobulin","volume":"85","author":"INTERNATIONAL FORUM","year":"2003","journal-title":"Vox Sang"},{"key":"e_1_2_9_11_2","first-page":"323","article-title":"Guideline for prevention of RhD alloimmunization in RhD negative women","volume":"75","author":"Lubusky M","year":"2010","journal-title":"Ceska Gynekol"},{"key":"e_1_2_9_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD000020"},{"key":"e_1_2_9_13_2","first-page":"3","volume-title":"Guidelines for laboratory assessment of fetomaternal haemorrhage","author":"Scientific Subcommittee of the Australian and New Zealand Society of Blood Transfusion","year":"2002"},{"key":"e_1_2_9_14_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2006.tb00414.x"},{"key":"e_1_2_9_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0029-7844(02)02180-4"},{"key":"e_1_2_9_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(87)90228-6"},{"key":"e_1_2_9_17_2","doi-asserted-by":"publisher","DOI":"10.1046\/j.1537-2995.1990.30490273444.x"},{"key":"e_1_2_9_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(86)90725-8"},{"key":"e_1_2_9_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9378(90)91083-O"},{"key":"e_1_2_9_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejogrb.2010.03.008"},{"key":"e_1_2_9_21_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.moh.0000245687.09215.c4"},{"key":"e_1_2_9_22_2","first-page":"443","article-title":"Possibility to identify fetomaternal haemorrhage","volume":"75","author":"Studnickova M","year":"2010","journal-title":"Ceska Gynekol"},{"key":"e_1_2_9_23_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e3181da7929"},{"key":"e_1_2_9_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0412.2010.01045.x"}],"container-title":["Transfusion"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1537-2995.2011.03536.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1537-2995.2011.03536.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,14]],"date-time":"2023-10-14T15:23:50Z","timestamp":1697297030000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1537-2995.2011.03536.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2012,2,8]]},"references-count":23,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2012,9]]}},"alternative-id":["10.1111\/j.1537-2995.2011.03536.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1537-2995.2011.03536.x","archive":["Portico"],"relation":{},"ISSN":["0041-1132","1537-2995"],"issn-type":[{"value":"0041-1132","type":"print"},{"value":"1537-2995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2012,2,8]]}}}